Enrollment and Plan Coverage

Learn More About Your Coverage

With the Optima Health Vantage Plan, members may receive services at any participating provider in the Optima Health Vantage network throughout Virginia and northeastern North Carolina.

The plan is available to Commonwealth of Virginia employees in the Greater Hampton Roads Area. The plan is also available to The Local Choice employees whose employer has selected Optima Health as a plan offering.

Additional requirements are that enrolling employees must live or work in the Greater Hampton Roads region as highlighted in the map below. Enrollment opportunities are available at the annual election period for your employer group or during a special enrollment period following a qualifying event.

Find out if you can enroll by using our zip code tool or the enrollment map below:

Cova and TLC coverage map

  • Greater Hampton Roads region

    Chesapeake Mathews Suffolk
    City of Franklin Newport News Surry
    Gloucester Norfolk Virginia Beach
    Hampton Poquoson Williamsburg
    Isle of Wight Portsmouth York
    James City Southampton
  • How do I know if I'm eligible for enrollment?

    The Optima Health Vantage Plan is available to Commonwealth of Virginia employees in the Greater Hampton Roads Area.  The plan is also available to The Local Choice employees whose employer has selected Optima Health as a plan offering.  Additional requirements are that enrolling employees must live or work in the Greater Hampton Roads region which is defined as: Chesapeake, City of Franklin, Gloucester, Hampton, Isle of Wright, James City, Mathews, Newport News, Norfolk, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York.  Enrollment opportunities are available at the annual election period for your employer group or during a special enrollment period following a qualifying life event.

    You can also download a complete listing of eligible enrollment areas.

  • How can I choose Optima Health?

    Enroll in the Optima Health Vantage HMO Plan through one of two methods:

    • Commonwealth of Virginia employees: Enroll in the Optima Health Vantage HMO by Employee Direct at www.dhrm.virginia.gov or by completing and returning an enrollment form to your agency's benefits administrator.
    • The Local Choice employees: Your employer must have selected Optima Health as a plan choice for your group. Check with your employer's benefits administrator for enrollment process details.
  • Does the plan coverage extend beyond Hampton Roads?

    Yes.  Members of the Optima Health Vantage HMO may receive services at any participating provider in the Vantage HMO network which covers the Commonwealth of Virginia and parts of northeastern North Carolina.  The plan also includes out-of-area-dependent coverage for children living outside the state (for example away at college.) 

    If you are unsure about coverage in your area, then use the find doctors instructions to discover if network coverage is available in your area of interest.

    In addition Virtual Visits are covered at no cost to you, when MDLive is accessed through Optima Health.

  • Do I have coverage while traveling outside of Virginia or the United States?

    As part of your Optima Health Vantage HMO Plan you can receive travel assistance that can handle your medical emergencies while on travel. You and any dependents on your Optima Health Plan are covered when traveling 100 miles or more away from your permanent residence, or to another country. Treatment and services, other than emergency services, received while traveling outside of the United States of America are not covered.